When Is It Time to Consider a Hysterectomy?
As one of the most common surgeries performed on women in the United States, a hysterectomy can help treat a myriad of gynecological conditions, including fibroids and endometriosis. However, there are several factors to consider when it comes to reproductive health and contemplating a hysterectomy. Fortunately, the providers at The Center for Innovative GYN Care® (CIGC) are here to help you weigh your options and allow you to choose the best treatment for your individual needs.
What Is a Hysterectomy?
A hysterectomy is a surgical procedure that involves the removal of the uterus. There are several types of hysterectomies, classified by how much tissue needs to be removed:
- Hysterectomy without removal of the ovaries: only the uterus, fallopian tubes, and cervix are removed.
- Supracervical hysterectomy: the uterus is removed above (“supra”) the cervix, keeping it intact, the fallopian tubes are removed, and the ovaries can either be removed or retained.
- Complete hysterectomy with removal of the ovaries: the uterus, fallopian tubes, cervix, and ovaries are removed.
There are a few different ways a hysterectomy can be performed, but the surgeons at CIGC exclusively use the world-renowned DualportGYN technique, which is an advanced outpatient surgical approach that, when compared to open or robotic surgery, allows for:
- Smaller incisions
- Fewer complications
- Shorter recovery time
- Less pain
What Conditions Can a Hysterectomy Treat?
A hysterectomy can treat several conditions and provide a long-term solution for patients suffering from painful symptoms who no longer wish to maintain fertility. Non-surgical options are typically only successful in the earlier stages of these conditions, but they are often ineffective in the long term. Here are the some of the most common reasons women seek a hysterectomy:
Abnormal bleeding is among the most frequent reasons why women consider a hysterectomy. This condition is characterized by menstrual flow greater than seven days, or when blood loss has exceeded 80cc, and by women who experience their menstrual cycle within an interval of fewer than 21 days or greater than 35 days. Abnormal bleeding can be extremely debilitating and make everyday activities difficult.
Other treatments for this condition include dilation and curettage, a short-term solution, and endometrial ablation, which uses thermal energy to destroy the endometrial lining. However, a hysterectomy is a solution for those who are not candidates for endometrial ablation and may provide a long-term solution for this condition.
Endometriosis is a GYN condition that occurs when the tissue that lines the uterus grows outside of the uterus, sometimes growing on the ovaries, fallopian tubes, or other organs in the pelvis. There are three types of endometriosis:
- Superficial peritoneal lesions
- Ovarian endometriomas
- Deep infiltrating endometriosis
These three types can be classified into four stages: minimal, mild, moderate, and severe. However, the stages of endometriosis do not always correspond with the severity of symptoms.
Surgical management is always recommended to successfully treat endometriosis. Delaying surgery may cause the disease to spread further and exacerbate already painful symptoms. With surgical treatment, endometriosis can be removed, and it may prevent the condition from returning. CIGC may recommend the following procedures, such as:
- Endometriosis excision
- Resection of ovarian endometriomas
Fibroids are non-cancerous growths that develop in the uterus. They affect about 80% of women and may lead to heavy bleeding, pain, infertility, and other issues. There are a few different ways to treat fibroids, and early detection is key to preventing them from damaging the uterus.
Frequently, a myomectomy is used to remove the fibroids while keeping the uterus intact. However, the larger the fibroids removed, the greater chance it can lead to scarring and abnormal healing in the uterus. Due to these risks, a hysterectomy may be considered to remove fibroids and prohibit the recurrence of fibroids.
Adenomyosis is a condition in which the tissue that lines the uterus starts to grow on the uterine wall, often leading to an expanded uterus. While some patients experience almost no symptoms at all, adenomyosis may lead to:
- Severe pelvic pain
- Abnormal bleeding
- Leg or back pain
- Pelvic pressure
- Abdominal bloating
- Pain during intercourse
Your physician may recommend medications and hormone therapy, but a hysterectomy is the only true cure for adenomyosis. Unlike fibroids, there is no definitive border between adenomyosis and normal uterine tissue, meaning it is impossible to remove the growths without damaging the uterus.
A prolapsed uterus occurs when the uterus descends into the vagina. This condition can happen when the muscles and ligaments that support the uterus become weak, often due to one or more vaginal childbirths. Uterine prolapse may cause:
- Back pain
- Urinary incontinence
- Difficulty during intercourse
- Protruding tissue from your vagina
- A sensation of heaviness in your pelvis
- Bowel issues
A hysterectomy can resolve these issues by entirely removing the uterus.
Cancer is another serious reason to consider a hysterectomy. One early indicator of cancer is the development of cervical dysplasia, in which the cells of the cervix become abnormal or precancerous. In its advanced stages, a hysterectomy may be the only treatment option for the following:
- Cervical cancer
- Ovarian cancer
- Uterine cancer
What to Consider Before Your Hysterectomy
Deciding to undergo a hysterectomy is a momentous decision in your life that should not be taken lightly. When making the decision if you should receive one and which type, you should take into consideration:
- Underlying conditions
- Overall health
- Size of the uterus
- Age and preferences
- Family planning
If you have a family history of ovarian or breast cancer, it may be beneficial to get a hysterectomy, where your cervix is removed. When this is done, you no longer need to have cervical screenings as it eliminates your chances of developing ovarian and cervical cancer in the future.
If your ovaries are removed during your hysterectomy, you will begin menopause after your procedure. The onset of menopause can lead to:
- Hot flashes
- Night sweats
- Vaginal dryness
- Mood fluctuations
- Difficulty sleeping
- Weight gain
To help alleviate symptoms of menopause, your GYN specialist may prescribe hormone replacement therapy. If you opt to keep your ovaries, you will not begin menopause immediately, but you will likely experience it within five years of your operation.
One of the most significant side effects of having a hysterectomy is that you are no longer able to bear children. Although some women may feel relief about no longer needing birth control, other women may feel upset over their loss of fertility. If you still hope to get pregnant, you may want to consider other treatment options.
For women hoping to preserve their fertility, the GYN specialists at CIGC may recommend the Laparoscopically Assisted Abdominal Myomectomy (LAAM®), which is a surgical technique used to remove uterine fibroids. This minimally invasive procedure offers a two-week recovery period with two small incisions and can remove up to 160 fibroids at a time.
Other side effects that result from a hysterectomy may include some temporary:
- Vaginal bleeding or discharge
- Abdominal swelling
Once these symptoms resolve, numerous patients report a significantly improved quality of life. After suffering from years of bleeding and discomfort, patients now have increased energy and faster metabolisms, allowing them to lose weight and be more active. In some cases, a hysterectomy provides life-saving care, inspiring patients to live life to the fullest.
Explore Your Options at CIGC
GYN conditions can have a substantial impact on your quality of life, which is why CIGC offers advanced laparoscopic GYN surgical techniques to relieve women of their pain.
If you’re suffering from any of the above complex GYN conditions, talk to a CIGC specialist today to find out if a hysterectomy is right for you.
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